I LOVE this quote: “Plastic surgery should whisper, not scream. Today, instead of tightening the neck, there is a re-suspending of the muscles in the face,” said Dr. Darrick Antell, a New York City plastic surgeon.

The face lift trends of today are more about re-filling and re-surfacing – and much less about tightening, pulling and tucking the skin. “The result is a much more natural look that’s fresher and younger, rather than lifts of days gone by that scream tight, frozen, and emotionless (think Joan Rivers!). Although personally, while I think the naturalization of face lifts is great; the overabundance of Botox is filling in for the tight, taut, frozen look.

So smaller, more frequent, nips and fills are being replaced by the grand face lifts of yesterday. The other benefit of this is the recovery time, since there are less bruising and lower complication rates.

The “midface” is the focus – the midface starts at the corners of your mouth, up diagonally towards the corners of your eyes. Think *cheekbones.*

When your face ages, fat is loosening and descending to sit lower in your face, resulting in facial features that look longer and squarer in shape. Younger faces tend to look angular or tapered. That’s why the most important aspect of a facelift is to improve facial shape while limiting signs that a surgical procedure has been performed. How do you do this? By manipulating both fat and muscle – the focus has significantly moved away from skin tension (although of course it is still important – no one wants a sagging face plumped with fat) and concentrates on contouring the face.

The best plastic surgeons are the ones that have mastered manipulating both the muscle and the fat in the face. The muscle in the face (musculoaponeurotic system [SMAS]) is addressed by repositioning underlying facial muscles as well as reducing excess skin. Fat and tissue contribute almost equally to your facial appearance as does the underlying muscle and the overlying skin. So depending on your face, fat will have to be added (via a fat transfer), reduced, or redistributed.

On the Upper East Side of Manhattan, Dr. David Rosenberg, a plastic surgeon, has a goal for the face lifts he performs – to give his patients “an age appropriate rejuvenation where they look absolutely fabulous for their age.” Dr Rosenberg continues, “It’s not as much a pulling back of the skin as it is a muscle correction. In the cheek, I go under the fat pad and re-support it to a place where it was earlier in time to recreate a younger looking cheek. I go under the muscles along the jaw line and neck, and re-support them back to a more youthful position.”

Current reports are saying face lifts are up 14% this year. What do you think? Are you one of the people that will inflate these statistics in the years to come?